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Brain Advance Access published online on February 10, 2005
Brain, doi:10.1093/brain/awh413
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© The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received September 14, 2004
Revised December 7, 2004
Accepted January 4, 2005

Article

The functional anatomy of divided attention in amnestic mild cognitive impairment

Thomas M. Dannhauser 1, Zuzana Walker 2*, Tim Stevens 3, Lean Lee 3, Marc Seal 4, and Sukhwinder S. Shergill 5

1 Institute of Psychiatry, King's College London, London, UK; University College London and Royal Free Hospitals, London, UK
2 University College London and Royal Free Hospitals, London, UK; North Essex Mental Health Partnership NHS Trust, Epping, UK
3 North Essex Mental Health Partnership NHS Trust, Epping, UK
4 Institute of Psychiatry, King's College London, London, UK
5 Institute of Psychiatry, King's College London, London, UK; Wellcome Department of Imaging Sciences, Institute of Neurology, University College London, London, UK

* To whom correspondence should be addressed.
Zuzana Walker, E-mail: z.walker{at}ucl.ac.uk


  Abstract

Summary Recent neuroimaging studies have demonstrated changes in brain function in cognitively normal subjects at increased risk of developing Alzheimer's disease. Amnestic mild cognitive impairment (AMCI) carries a high risk of developing into Alzheimer's disease. In AMCI altered cortical activation has been demonstrated during memory tasks, using functional MRI (fMRI). Memory and attention are closely related cognitive functions. It is unclear whether the memory impairment of AMCI is associated with attentional deficits of the sort likely to be revealed by tasks requiring divided attention. Ten older adults (mean age 72 years, range 57-81 years) with AMCI were compared with healthy matched controls on divided attention and passive sensory processing tasks using fMRI. During the divided attention task both groups activated similar regions of left hemispheric prefrontal and extrastriate visual cortex. However, the AMCI group had attenuated prefrontal activation compared with age matched controls. On the passive sensory processing task there was no difference between the AMCI and control groups. We conclude that there are changes in the functional network subserving divided attention in patients with AMCI as reflected in the attenuation of prefrontal cortical activation. These findings have implications for evaluating cognition in AMCI and also for monitoring the effects of future treatments in AMCI.

Keywords: amnestic mild cognitive impairment; Alzheimer's disease; divided attention; functional MRI.
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